Individual provider Active NPI

Cameron Cobb, DNP, APRN, FNP-C

  • Family Nurse Practitioner
  • Raleigh, NC
National Provider Identifier
1104413251
Registry record updated Dec 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
66460 Issued in ID
Practice address
4201 Lake Boone TRL Ste 5
Raleigh, NC 27607-7511
Phone
(984) 222-8000
NPI assigned
Dec 23, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 66460 ID Primary

Addresses

Primary practice location

4201 Lake Boone TRL Ste 5
Raleigh, NC 27607-7511

Mailing address

4201 Lake Boone TRL Ste 5
Raleigh, NC 27607-7511

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210804002954 NC Practitioner - Nurse Practitioner 3971907528 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

500 Eastowne Dr
Chapel Hill, NC 27514-2244

Hospital & facility affiliations

  • Unc Hospitals Hospital, Chapel Hill, NC, CCN 340061
  • Rex Hospital Hospital, Raleigh, NC, CCN 340114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
66460IDMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of North Carolina at Chapel Hill CurrentSince Nov 13, 2023 Accepting new patients
Park Ophthalmology Past Accepting new patients

Locations

1807 Fordham Blvd
Chapel Hill, NC 27514
Phone (919) 595-9641

101 Manning Dr
Chapel Hill, NC 27514
Phone (984) 974-1485

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1608681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608681600000",
    "number": "1104413251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 LAKE BOONE TRL STE 5",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 LAKE BOONE TRL STE 5",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276077511",
            "telephone_number": "984-222-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COBB",
        "first_name": "CAMERON",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-12-23",
        "last_updated": "2020-12-23",
        "certification_date": "2020-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "ID",
            "license": "66460",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.